|
HC ANKLE LIMITED
|
Facility
|
IP
|
$959.00
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
909001642
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$191.80 |
| Max. Negotiated Rate |
$863.10 |
| Rate for Payer: Adventist Health Commercial |
$191.80
|
| Rate for Payer: Cash Price |
$527.45
|
| Rate for Payer: Central Health Plan Commercial |
$767.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$383.60
|
| Rate for Payer: EPIC Health Plan Senior |
$383.60
|
| Rate for Payer: Galaxy Health WC |
$815.15
|
| Rate for Payer: Global Benefits Group Commercial |
$575.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$863.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$639.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$365.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$593.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.80
|
| Rate for Payer: Multiplan Commercial |
$719.25
|
| Rate for Payer: Networks By Design Commercial |
$623.35
|
| Rate for Payer: Prime Health Services Commercial |
$815.15
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$2,436.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$487.20 |
| Max. Negotiated Rate |
$2,192.40 |
| Rate for Payer: Adventist Health Commercial |
$487.20
|
| Rate for Payer: Cash Price |
$1,339.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,948.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$974.40
|
| Rate for Payer: EPIC Health Plan Senior |
$974.40
|
| Rate for Payer: Galaxy Health WC |
$2,070.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,461.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,192.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,624.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$928.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,507.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.20
|
| Rate for Payer: Multiplan Commercial |
$1,827.00
|
| Rate for Payer: Networks By Design Commercial |
$1,583.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,070.60
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$2,436.00
|
|
|
Service Code
|
CPT 91122
|
| Hospital Charge Code |
906791122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$103.84 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$487.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$217.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,430.66
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,339.80
|
| Rate for Payer: Cash Price |
$1,339.80
|
| Rate for Payer: Cash Price |
$1,339.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,948.80
|
| Rate for Payer: Cigna of CA HMO |
$1,559.04
|
| Rate for Payer: Cigna of CA PPO |
$1,802.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$2,070.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,461.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,192.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$103.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,624.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$1,827.00
|
| Rate for Payer: Networks By Design Commercial |
$1,583.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$2,070.60
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,461.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC ANOSCOPY AND BIOPSY
|
Facility
|
OP
|
$8,874.00
|
|
|
Service Code
|
CPT 46606
|
| Hospital Charge Code |
904000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.95 |
| Max. Negotiated Rate |
$7,986.60 |
| Rate for Payer: Adventist Health Commercial |
$1,774.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,422.01
|
| Rate for Payer: Blue Shield of California EPN |
$3,540.73
|
| Rate for Payer: Cash Price |
$4,880.70
|
| Rate for Payer: Cash Price |
$4,880.70
|
| Rate for Payer: Cash Price |
$4,880.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,099.20
|
| Rate for Payer: Cigna of CA HMO |
$5,679.36
|
| Rate for Payer: Cigna of CA PPO |
$6,566.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$7,542.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,324.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,986.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$49.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,918.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$6,655.50
|
| Rate for Payer: Networks By Design Commercial |
$5,768.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$7,542.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,324.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,324.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,437.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC ANOSCOPY AND BIOPSY
|
Facility
|
IP
|
$8,874.00
|
|
|
Service Code
|
CPT 46606
|
| Hospital Charge Code |
904000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,774.80 |
| Max. Negotiated Rate |
$7,986.60 |
| Rate for Payer: Adventist Health Commercial |
$1,774.80
|
| Rate for Payer: Cash Price |
$4,880.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,099.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,549.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,549.60
|
| Rate for Payer: Galaxy Health WC |
$7,542.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,324.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,986.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,918.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,380.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,493.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,774.80
|
| Rate for Payer: Multiplan Commercial |
$6,655.50
|
| Rate for Payer: Networks By Design Commercial |
$5,768.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,542.90
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$567.90 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$390.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$567.90 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$390.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$258.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$370.59
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.50
|
| Rate for Payer: United Healthcare All Other HMO |
$315.50
|
| Rate for Payer: United Healthcare HMO Rider |
$315.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$315.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$305.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$370.59
|
| Rate for Payer: Blue Shield of California Commercial |
$385.54
|
| Rate for Payer: Blue Shield of California EPN |
$251.77
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.50
|
| Rate for Payer: United Healthcare All Other HMO |
$315.50
|
| Rate for Payer: United Healthcare HMO Rider |
$315.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$315.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC ANOSCOPY DIAGNOSTIC W WO SPEC COLLECT
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
900501159
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$567.90 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Cash Price |
$347.05
|
| Rate for Payer: Central Health Plan Commercial |
$504.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$567.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$390.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.20
|
| Rate for Payer: Multiplan Commercial |
$473.25
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.14 |
| Max. Negotiated Rate |
$4,542.30 |
| Rate for Payer: Adventist Health Commercial |
$1,009.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,845.73
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: Cigna of CA HMO |
$3,230.08
|
| Rate for Payer: Cigna of CA PPO |
$3,734.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,366.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,028.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,523.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,523.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,523.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,523.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
OP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$205.14 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$2,069.27
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,845.73
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: Cigna of CA HMO |
$3,230.08
|
| Rate for Payer: Cigna of CA PPO |
$3,734.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,366.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,028.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,028.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,009.40 |
| Max. Negotiated Rate |
$4,542.30 |
| Rate for Payer: Adventist Health Commercial |
$1,009.40
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,018.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,018.80
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,366.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,922.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,124.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
|
|
HC ANOSCOPY DIAG W/RMVL FB
|
Facility
|
IP
|
$5,047.00
|
|
|
Service Code
|
CPT 46608
|
| Hospital Charge Code |
900501160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,009.40 |
| Max. Negotiated Rate |
$4,542.30 |
| Rate for Payer: Adventist Health Commercial |
$1,009.40
|
| Rate for Payer: Cash Price |
$2,775.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,037.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,018.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,018.80
|
| Rate for Payer: Galaxy Health WC |
$4,289.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,028.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,542.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,366.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,922.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,124.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,009.40
|
| Rate for Payer: Multiplan Commercial |
$3,785.25
|
| Rate for Payer: Networks By Design Commercial |
$3,280.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,289.95
|
|
|
HC ANOSCOPY REMOVE LESION
|
Facility
|
IP
|
$4,163.00
|
|
|
Service Code
|
CPT 46610
|
| Hospital Charge Code |
904000012
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$832.60 |
| Max. Negotiated Rate |
$3,746.70 |
| Rate for Payer: Adventist Health Commercial |
$832.60
|
| Rate for Payer: Cash Price |
$2,289.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,330.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,665.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,665.20
|
| Rate for Payer: Galaxy Health WC |
$3,538.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,746.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,776.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,586.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,576.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$832.60
|
| Rate for Payer: Multiplan Commercial |
$3,122.25
|
| Rate for Payer: Networks By Design Commercial |
$2,705.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,538.55
|
|
|
HC ANOSCOPY REMOVE LESION
|
Facility
|
OP
|
$4,163.00
|
|
|
Service Code
|
CPT 46610
|
| Hospital Charge Code |
904000012
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$156.24 |
| Max. Negotiated Rate |
$5,714.55 |
| Rate for Payer: Adventist Health Commercial |
$832.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,484.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,543.59
|
| Rate for Payer: Blue Shield of California EPN |
$1,661.04
|
| Rate for Payer: Cash Price |
$2,289.65
|
| Rate for Payer: Cash Price |
$2,289.65
|
| Rate for Payer: Cash Price |
$2,289.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,330.40
|
| Rate for Payer: Cigna of CA HMO |
$2,664.32
|
| Rate for Payer: Cigna of CA PPO |
$3,080.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$3,538.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,497.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,746.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,776.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$832.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$3,122.25
|
| Rate for Payer: Networks By Design Commercial |
$2,705.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Prime Health Services Commercial |
$3,538.55
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,497.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,497.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,081.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,081.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,081.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,081.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC ANOSCOPY W CONTRL OF BLEEDNG
|
Facility
|
IP
|
$3,853.00
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
906746614
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$770.60 |
| Max. Negotiated Rate |
$3,467.70 |
| Rate for Payer: Adventist Health Commercial |
$770.60
|
| Rate for Payer: Cash Price |
$2,119.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,082.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,541.20
|
| Rate for Payer: Galaxy Health WC |
$3,275.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,311.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,467.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,569.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,467.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,385.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.60
|
| Rate for Payer: Multiplan Commercial |
$2,889.75
|
| Rate for Payer: Networks By Design Commercial |
$2,504.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,275.05
|
|
|
HC ANOSCOPY W CONTRL OF BLEEDNG
|
Facility
|
OP
|
$3,853.00
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
906746614
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$205.56 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$770.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,119.15
|
| Rate for Payer: Cash Price |
$2,119.15
|
| Rate for Payer: Cash Price |
$2,119.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,082.40
|
| Rate for Payer: Cigna of CA HMO |
$2,465.92
|
| Rate for Payer: Cigna of CA PPO |
$2,851.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$3,275.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,311.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,467.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$205.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,569.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,889.75
|
| Rate for Payer: Networks By Design Commercial |
$2,504.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$3,275.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,311.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC ANS PARASYMP & SYMP W TILT
|
Facility
|
OP
|
$865.00
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
900600331
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$173.00 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$173.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$525.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$382.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$508.01
|
| Rate for Payer: Blue Shield of California Commercial |
$525.05
|
| Rate for Payer: Blue Shield of California EPN |
$343.40
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Central Health Plan Commercial |
$692.00
|
| Rate for Payer: Cigna of CA HMO |
$553.60
|
| Rate for Payer: Cigna of CA PPO |
$640.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$735.25
|
| Rate for Payer: Global Benefits Group Commercial |
$519.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$778.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$221.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: InnovAge PACE Commercial |
$593.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$576.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$530.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$648.75
|
| Rate for Payer: Networks By Design Commercial |
$562.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.66
|
| Rate for Payer: Prime Health Services Commercial |
$735.25
|
| Rate for Payer: Prime Health Services Medicare |
$419.40
|
| Rate for Payer: Riverside University Health System MISP |
$435.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$519.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$519.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC ANS PARASYMP & SYMP W TILT
|
Facility
|
IP
|
$865.00
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
900600331
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$173.00 |
| Max. Negotiated Rate |
$778.50 |
| Rate for Payer: Adventist Health Commercial |
$173.00
|
| Rate for Payer: Cash Price |
$475.75
|
| Rate for Payer: Central Health Plan Commercial |
$692.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$346.00
|
| Rate for Payer: EPIC Health Plan Senior |
$346.00
|
| Rate for Payer: Galaxy Health WC |
$735.25
|
| Rate for Payer: Global Benefits Group Commercial |
$519.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$778.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$576.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$329.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$535.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.00
|
| Rate for Payer: Multiplan Commercial |
$648.75
|
| Rate for Payer: Networks By Design Commercial |
$562.25
|
| Rate for Payer: Prime Health Services Commercial |
$735.25
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
915352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$83.00
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$228.25
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$158.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$256.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.00
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$269.75
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
915352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$135.91 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$170.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$228.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.73
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$228.25
|
| Rate for Payer: Cash Price |
$228.25
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$352.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$352.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$352.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$253.75
|
| Rate for Payer: InnovAge PACE Commercial |
$207.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$256.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$290.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$290.50
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$207.50
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: Riverside University Health System MISP |
$166.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$249.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$352.75
|
| Rate for Payer: Vantage Medical Group Senior |
$352.75
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
905352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$135.91 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$170.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$228.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$311.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.73
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$228.25
|
| Rate for Payer: Cash Price |
$228.25
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$352.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$352.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$352.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$253.75
|
| Rate for Payer: InnovAge PACE Commercial |
$207.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$280.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$256.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$290.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$290.50
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$207.50
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: Riverside University Health System MISP |
$166.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$249.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$352.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$352.75
|
| Rate for Payer: Vantage Medical Group Senior |
$352.75
|
|
|
HC ANTERIOR SWING BAND ADDITION LE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT L2335
|
| Hospital Charge Code |
905352335
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$373.50 |
| Rate for Payer: Adventist Health Commercial |
$83.00
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$209.16
|
| Rate for Payer: Cash Price |
$228.25
|
| Rate for Payer: Central Health Plan Commercial |
$332.00
|
| Rate for Payer: Cigna of CA HMO |
$290.50
|
| Rate for Payer: Cigna of CA PPO |
$290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$166.00
|
| Rate for Payer: Galaxy Health WC |
$352.75
|
| Rate for Payer: Global Benefits Group Commercial |
$249.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$373.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$276.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$158.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$256.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.00
|
| Rate for Payer: Multiplan Commercial |
$311.25
|
| Rate for Payer: Networks By Design Commercial |
$269.75
|
| Rate for Payer: Prime Health Services Commercial |
$352.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$155.75
|
| Rate for Payer: United Healthcare All Other HMO |
$151.60
|
| Rate for Payer: United Healthcare HMO Rider |
$148.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.91
|
|
